中国中西医结合肾病杂志
中國中西醫結閤腎病雜誌
중국중서의결합신병잡지
CHINESE JOURNAL OF INTEGRATED TRADITIONAL AND WESTERN NEPHROLOGY
2014年
12期
1059-1065
,共7页
戚莉%王晓柠%刘平%刘成海
慼莉%王曉檸%劉平%劉成海
척리%왕효저%류평%류성해
肾纤维化%中药%随机对照试验%系统评价%Meta分析
腎纖維化%中藥%隨機對照試驗%繫統評價%Meta分析
신섬유화%중약%수궤대조시험%계통평개%Meta분석
Traditional Chinese medicine%Renal fibrosis%Randomized controlled trial%Systematic review%Meta-a-nalysis
目的:系统评价中药口服治疗肾纤维化的临床疗效。方法:计算机检索 The Cochrane library(2013年第10期)、PubMed、EMbase、VIP、万方、CNKI、CBM中关于中药口服治疗慢性肾病肾纤维化的随机对照试验( RCT),检索时限均为从建库至2014年3月。由两名研究者按照纳入和排除标准独立进行文献筛选、资料提取、质量评价并交叉核对,采用Rev-Man 5.2软件进行meta分析。结果:最终纳入12个RCT,共828例患者。与对照组相比,在常规西药治疗的基础上加用中药口服,可明显降低Scr与BUN含量(P<0.05);并可降低血清PCⅢ、Ⅳ-C、LN、HA及尿CTGF、TGF-β1等肾纤维化指标(P<0.05),且现有研究无不良反应报道。结论:现有证据表明,在西医常规药物的基础上加用中药口服治疗慢性肾病肾纤维化,其效果明显优于单纯常规西药治疗。常用的口服中药为补益活血化瘀类。因纳入研究存在一定的方法学问题,上述结论尚需今后开展更高质量的相关研究加以验证。
目的:繫統評價中藥口服治療腎纖維化的臨床療效。方法:計算機檢索 The Cochrane library(2013年第10期)、PubMed、EMbase、VIP、萬方、CNKI、CBM中關于中藥口服治療慢性腎病腎纖維化的隨機對照試驗( RCT),檢索時限均為從建庫至2014年3月。由兩名研究者按照納入和排除標準獨立進行文獻篩選、資料提取、質量評價併交扠覈對,採用Rev-Man 5.2軟件進行meta分析。結果:最終納入12箇RCT,共828例患者。與對照組相比,在常規西藥治療的基礎上加用中藥口服,可明顯降低Scr與BUN含量(P<0.05);併可降低血清PCⅢ、Ⅳ-C、LN、HA及尿CTGF、TGF-β1等腎纖維化指標(P<0.05),且現有研究無不良反應報道。結論:現有證據錶明,在西醫常規藥物的基礎上加用中藥口服治療慢性腎病腎纖維化,其效果明顯優于單純常規西藥治療。常用的口服中藥為補益活血化瘀類。因納入研究存在一定的方法學問題,上述結論尚需今後開展更高質量的相關研究加以驗證。
목적:계통평개중약구복치료신섬유화적림상료효。방법:계산궤검색 The Cochrane library(2013년제10기)、PubMed、EMbase、VIP、만방、CNKI、CBM중관우중약구복치료만성신병신섬유화적수궤대조시험( RCT),검색시한균위종건고지2014년3월。유량명연구자안조납입화배제표준독립진행문헌사선、자료제취、질량평개병교차핵대,채용Rev-Man 5.2연건진행meta분석。결과:최종납입12개RCT,공828례환자。여대조조상비,재상규서약치료적기출상가용중약구복,가명현강저Scr여BUN함량(P<0.05);병가강저혈청PCⅢ、Ⅳ-C、LN、HA급뇨CTGF、TGF-β1등신섬유화지표(P<0.05),차현유연구무불량반응보도。결론:현유증거표명,재서의상규약물적기출상가용중약구복치료만성신병신섬유화,기효과명현우우단순상규서약치료。상용적구복중약위보익활혈화어류。인납입연구존재일정적방법학문제,상술결론상수금후개전경고질량적상관연구가이험증。
Objective:To evaluate the effectiveness of taking Traditional Chinese medicine( TCM)orally for renal fibrosis ( RF). Methods:Such databases as the Cochrane library( Issue 10,2013),PubMed,EMbase,VIP,CNKI,CBM and WanFang Da-ta were searched from the inception to March,2014 to collect the randomized controlled trials( RCTs)about taking TCM orally in treating RF. Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted the data, and evaluated and cross-checked the methodological quality. Then meta-analysis was conducted using RevMan 5. 2 software. Re-sults:A total of 12 RCTs were included. Compared with the control group,the TCM group better promoted the recovery of renal func-tion by more reduction of Scr and BUN(P<0. 05). Taking TCM orally could treat renal fibrosis more effectively than control groups in PCⅢ,Ⅳ-C,LN,HA,CTGF and TGF-β1(P<0. 05). Conclusion:Combination of TCM with Western medicine therapies were more effective for renal fibrosis than Western medicine therapies only . It needs more multi-center,large samples and double blind RCTS. Furthermore standardized reports of the adverse reaction are needed.